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From question on page 876

Because of the risk of bleeding through ultrasound guided transthoracic needle biopsy, the patient underwent video assisted thoracoscopic surgery for right lower lung biopsy. Histopathology of the biopsy specimens revealed collections of monotonous small lymphoid cells that were immunoreactive to CD20 but negative for CD3, CD5, CD43 and cyclin D1. Lymphoepithelial lesions and several caseating granuloma with Langhans’ giant cells were also found (fig 1A, B).

Figure 1 Histopathology and immunohistochemical findings. (A) The mucosa associated lymphoid tissue lymphoma (MALToma) cells were small, monotonous with cleaved nuclei and admixed with caseating granuloma and multinucleated giant cells (stain: haematoxylin and eosin; original magnification ×66). (B) The MALToma cells were immunoreactive to CD20.

The diagnosis of coexisting primary pulmonary B cell mucosa associated lymphoid tissue lymphoma (MALToma) and pulmonary tuberculosis in the same …

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